Stand Up for Nurses

Today I worked at the hospital again even though it was supposed to be my day off. I got a call from the staffing office at 6 am, but didn't pick up the message until I woke up at 7 am. The hospital was short staffed again, & I didn't have the strength to turn down the overtime pay. I ended up working on the Oncology floor taking care of 5 patients: a 34-year-old woman with a new diagnosis of ovarian cancer; a 41-year-old father of young children with recurrent glioblastoma (brain tumor); a 65-year-old woman with a new diagnosis of lung cancer; a 60-year-old woman with breast cancer (she refused chemotherapy a year ago & now had metastases to her spine, liver & lungs); & a 70-year-old man with severe anemia due to recent chemotherapy & radiation. This assignment was complex & also very typical. It was a busy & tiring, but as usual, rewarding shift. I was in charge of reviewing doctors' orders, performing patient assessments, administering medications, helping with turns & toileting, communicating with families, & constant patient care prioritizing while receiving & processing multiple phone calls from various people & departments.
As often the norm, I didn't go for a break until almost 6 hours into my shift - starving, shaky, dizzy & with a bladder ready to explode by then. Almost every nurse I know does the same. One of my worst memories includes working while 8 months pregnant with Gerritt (By the way, did you know that pregnant nurses get the same patient assignment as everyone else?). I was very hungry & dizzy, but could not leave my patient since he was in the middle of an unexpected transfer to the ICU. Usually calm & collected, I lost it & started sobbing uncontrollably. After a quick snack of milk & crackers, thanks to my coworkers, I was able to finish my assignment. Another memory I have is overdosing a patient by incorrectly programming a patient controlled analgesia (PCA) device so it administered 10x the ordered drug amount. I was a recent nursing school grad & clearly remember suffering from hypoglycemia (low blood sugar), being in a hurry & feeling overwhelmed from my patient load being too heavy. After the error was discovered by another nurse & I was disciplined by the unit manager, I was told that "being tired would not fly well in court," should the hospital be sued. To this day I never know when & whether I'll be able to get my breaks & lunch, so I usually carry some dark chocolate & string cheese in my pocket to keep myself from passing out.
It's an unwritten rule - patients always come first. There is too much to do in a short amount of time. Nursing is an art, & caring is a big part of our job description. Unfortunately, there is no one to care for the nurse. With the hospital's recent change in nurse-to-patient ratio from 1:4 to 1:6, it's more difficult than ever to get the needed rest. It's well documented that nurse's fatigue & resulting decreased alertness jeopardizes patient safety. Even though now I spend most of my work hours helping patients in my role as a Nurse Practitioner, nursing issues are close to my heart. I perform a lot of medical tasks such as ordering diagnostic tests, formulating medical diagnoses & prescribing pharmaceuticals, but I am a nurse first.
That's why I was so happy to get the Washington State Nurses Association's (WSNA) email newsletter about the WSNA & Evergreen hospital settlement over nurse rest breaks this week. A few months ago, the WSNA filed a lawsuit over consistently missed rest breaks for nurses at the Evergreen. "The proposed settlement not only includes payment for rest breaks missed in the past, but also sets forth sweeping changes to the way rest breaks are handled at Evergreen. There will be extensive changes in timekeeping, payroll, & policy designed to ensure that taking rest breaks is the norm, that we are appropriately staffed to allow for breaks & that nurses are properly compensated when rest breaks are missed." I've been a nurse for almost 10 years & this is a truly groundbreaking & landmark settlement! Did you know that when I do take my 30-minute lunch break, I still have my work cell phone with me, so I can never get away from work completely? Thanks to the WSNA, their definition of a break now includes that it must be UNINTERRUPTED & that brief trips to the bathroom & getting a drink of water do not count as breaks. Isn't it sad that we have to be that specific?
Most of the public is largely unaware of the nursing shortage while it's projected to get worse. It only makes sense to take care of the nurses we have now to keep them from suffering "compassion fatigue" & burnout & leaving the profession all together. I will finish the post by advising to have someone by your side at all times if you are ever hospitalized. With the nursing shortage & nurses being as overworked & tired as they are, it is wise to have an advocate who would double check things for you. Take it from me, it just may save your life!